| NPI | 1558776583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: PR 19606) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 19606) |
| Enumeration Date | 2014-06-28 |
| Last Update Date | 2019-09-27 |